By Martin Mbonye
When I left Uganda for the London School of Hygiene and Tropical Medicine (LSHTM) in January 2020, Covid-19 was beginning to gain momentum. My visit was courtesy of the THRiVE Ph.D. fellowship that allows a research fellow to visit a designated institute in the United Kingdom. THRiVE stands for Training Health Researchers into Vocational Excellence (THRiVE) and is a regional network aimed at implementing high-quality scientific research training and producing research leaders in East Africa.
When I arrived in London, I could spot a few, almost exclusively, Chinese with face masks. Sooner, reports started appearing in the inner pages of the evening metro newspaper which was my main source of information. Then increasingly, more cases of COVID-19 were being reported in the UK. The LSHTM started organizing special committees to explore the novel virus but business was proceeding as usual and the London tubes were as crowded as ever. However, I made a conscious decision to move out of London because the television news channels had started reporting rising cases in different countries. My decision was driven by the fear that I could get infected through the mode of travel that I used daily. I moved to Leeds and it is from there that I was evacuated through Manchester airport, via Dubai to Entebbe. In Entebbe, I was placed under institutional quarantine.
The hellish quarantine
While departing Manchester, I was warned by airport officials to expect 14 days of quarantine in Uganda. When I arrived at Entebbe, the officials promptly read out a list of the category one countries in which COVID-19 cases had been reported. Those of us from such countries had a separate area to line up for clearance. Temperature measurements were taken and our passports removed from us at that point by health officials in full protective gear. Those who had been to Dubai and others from non-category one countries were allowed to proceed through the normal immigration procedures. We waited in some space at the airport under the close eye of a combination of the ministry of health officials and others in plainclothes security personnel. We never had any formal communication about what was going on until about two hours later when we were told where to pick our luggage and choose a hotel of our choice which would be our home for the next 14 days. There were a number of options available to us and my choice was informed by a conversation that I had with one of the less intimidating ministry officials who advised that I choose the Arch apartments in Ntinda. With what I had seen on videos earlier about the treatment of returnees in quarantine, I had reason to worry. At about 5 pm we entered a waiting bus and with a clear road, we arrived at our hotel.
When we arrived at the hotel, we were well received and offered our rooms. There was no briefing from the hotel staff or the ministry officials about the standard operating procedures for the quarantine. In any case, there were no ministry officials with us at the time. I was actually the one coordinating with the hotel using my phone on behalf of the others. The first few days were nerve-wracking as I sat in the room wondering whether it was not just a matter of time before symptoms of COVID -19 showed. Having arrived on the 21st of March 2020, my quick calculations showed that I would be living on the 4th of April. We got served in the rooms and there was no other person allowed into our rooms. We were allowed in the first few days to receive some non-food items at the hotel. The hotel, to their credit, tried their best to implement a strict institutional quarantine. For example, we had the same waiter for most of the time, attempts were made to use disposable utensils to a large extent and the hotel workers had face masks and gloves. Unfortunately, a few people in quarantine never respected the strict rules of the game and occasionally left rooms to get some fresh air and do some exercises. This threatened our 14-day quarantine and was used to extend the period beyond the 14 days.
The extension caused a lot of anxiety in the hotel and some people were on the verge of a psychological breakdown. Some people had tests done three times and despite being negative, were made to stay with the rest because of what they called abuse of the quarantine rules. We all felt like we were victims of a system we had no control over in terms of implementing the quarantine and yet we were blamed for the mistakes. The worst case was when we all had tests done after the extension and we even received a letter from the permanent secretary that we would all leave on the 8th of April if our results were negative. On the 7th of April, we received communication on the WhatsApp forum that had been started for support, that the results were out and we had all tested negative. We waited for release the next day only for no action to be taken until late in the evening when we received news on the forum that ambulances were arriving and seemed to be getting ready to pick a positive COVID 19 case. What was happening? We asked ourselves. We resigned ourselves to another 14 days and stayed put, almost numb for the next few days, with near to no communication at all. Some people took extreme measures to go on a hunger strike until a proper explanation was offered by officials. Suddenly two days later on the 10th of April we had another test done and later in the evening of the same day at around 5 pm, without any warning, we were released, and that marked the end of the chaotic quarantine.
While the idea of quarantine was welcome and almost all of us were happy to stay the 14 days, it could have been made more organized.
From this experience, these are my few observations and recommendations:
- The ministry ought to have communicated the standard operating procedures to each member of the quarantine team about their role in the process
- The security personnel at the quarantine center ought to have been briefed to implement a more strict policing of people who abused the rules
- The ministry should arrange with quarantine centers to have members access medical services and in particular psychosocial services for members going through the quarantine process
- Ministry officials and other leaders should be cautious in labeling people in quarantine. It is not a crime to travel out of the country. Such utterances led to some people in quarantine being targeted in their home communities